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Patient Assistance Information

Program Sponsored By QOL Medical (External Link)
Sucraid Patient Assistance Program

c/o Accredo Health Group, Inc.
1640 Century Center Pkwy
Memphis, TN 38134
Phone : (800)705-1962
Fax: 800-632-1944
> The patient must have no insurance and meet income guidelines that are not disclosed. The patient must also have an FDA approved diagnosis.
Who Can Apply
> With the patient's permission, anyone concerned can call for an application.
> The doctor must fill out a section, sign the application and attach a prescription.The patient must fill out a section, sign the application and attach insurance information.
> Up to a 30-day supply
Ship To
> Patient's home, unless otherwise noted
> This program also provides copay assistance.
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
Sucraid oral solution
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
Download printable Form
(Requires Acrobat Reader